Dark Medicine

Rationalizing Unethical Medical Research

Edited by William R. LaFleur, Gernot Böhme, and Susumu Shimazono

Publication Year: 2007

The trial of the "German doctors" exposed atrocities of Nazi
medical science and led to the Nuremberg Code governing human experimentation. In
Japan, Unit 731 carried out hideous experiments on captured Chinese and downed
American pilots. In the United States, stories linger of biological experimentation
during the Korean War. This collection of essays looks at the dark medical research
conducted during and after World War II. Contributors describe this research, how it
was brought to light, and the rationalizations of those who perpetrated and
benefited from it.

COVER

CONTENTS

PREFACE

Nations involved today in international competition in biotech research often behave like drivers in an old-fashioned stock-car race. Each is constantly aware of others in the race and uses anxiety about relative “position” to rationalize stepping harder on the accelerator and taking ever-greater risks.In fact, a kind of raw fear can grip the so-called advanced nations if there...

ACKNOWLEDGMENTS

This book had its origins in conversations, both in person and in cyberspace, among its three editors. We agreed on the urgency of raising the questions asked in these chapters—and decided to assemble world authorities on both the historical cases and the contemporary issues investigated here. Unwilling to imply that unethical medical research is a problem only of the past, we sought to explore...

INTRODUCTION: THE KNOWLEDGE TREE AND ITS DOUBLE FRUIT

Nearly two thousand years ago Marcus Aurelius articulated a standard that, if applied to the professions, held that all their members should “be upright, not be kept upright.” But this high ideal, we know by bitter experience, is unrealistic.The professions, including those of medicine, today enjoy the general public’s confidence in part because mechanisms have been put in place in order to keep...

PART ONE: THE GRUESOME PAST AND LESSONS NOT YET LEARNED

An anthology on bioethics recently published in Germany claimed in its preface that “the reception of many topics of bioethics occurred in Germany in light of what had taken place during the Third Reich. . . . It was the medical tests performed in the concentration camps, the Nazis’ euthanasia programs and the programs of racial puri¤cation that formed the background for the reception...

2. MEDICAL RESEARCH, MORALITY, AND HISTORY: THE GERMAN JOURNAL ETHIK AND THE LIMITS OF HUMAN EXPERIMENTATION

The issues surrounding the subject of human experimentation are among the most intractable ethical dilemmas in medicine for persons attempting to strike a balance between research interests and the well being of individuals.
The twentieth century witnessed great advances in medicine, but also severe
crimes in the name of science. More than fifty years after the end of the Nuremberg
Doctors’ Trial the decisive factors and the full repercussions...

3. EXPERIMENTATION ON HUMANS AND INFORMED CONSENT: HOW WE ARRIVED WHERE WE ARE

The practice of experimenting on humans dates back to antiquity, but we know few details from that time. The notion of experimental research came to fruition only once medicine had detached itself from the dogmatism of the ancient and medieval eras—that is, once the physician’s own eyes and what they observed, rather than the authority of the ancients, became the main point of reference...

4. THE SILENCE OF THE SCHOLARS

Science lives in the present. Its past does not interest scientists. One does not cite papers that are more than three years old, and the textbooks contain little history. Everything that was shown to be incorrect is forgotten—all the more so if it was not incorrect, but amoral and inhuman. Those who were close to such crimes claim not to have known anything. The student defends his teacher, and...

5. THE ETHICS OF EVIL: THE CHALLENGE AND THE LESSONS OF NAZI MEDICAL EXPERIMENTS

Most histories of medical ethics locate the origins of bioethics in the ashes of the German concentration camps. The Nuremberg Code is frequently held up in courses and textbooks on medical ethics as the “constitution” of human subjects research. But very little is said about the actual experiments that generated this document. And even less is said about the moral rationales those...

Unit 731 was officially inaugurated in the town of Ping Fan (near Harbin) in China in August of 1936 (Koseisho [Ministry of Health and Welfare]1982).1 Preparatory activities were already underway in the fall of 1932, however, in a shoyu (soy sauce) factory in a small village about one hundred kilometers southeast of Harbin (Endo 1981). In that year, Shiro Ishii, the man who...

7. BIOHAZARD: UNIT 731 IN POSTWAR JAPANESE POLITICS OF NATIONAL "FORGETFULNESS"

Japan and its citizens have an international reputation for historical amnesia. The battle by the Ministry of Education, Science, and Technology to tame references to wartime atrocities in Japanese textbooks has made the headlines in Western, as well as Asian, capitals over the last quarter century. These controversies have been accentuated in recent years by Prime Minister...

8. BIOLOGICAL WEAPONS: THE UNITED STATES AND THE KOREAN WAR

The advent of the “War on Terror” during the presidency of George W. Bushhas brought to the forefront the specter of “weapons of mass destruction.” The phrase was not particularly new, but in the past several years it has become ubiquitous in the media; in the abbreviated form WMD, it has become well known across the United States. The use of this term in the United States is somewhat disingenuous. That ...

I begin by conjuring for you the image of an explosion within the abdomen of an injured cat, shot in a wartime laboratory as part of a project to develop more effective bullets. My paper focuses on experimental injury, and on the ways that, as Donna Haraway suggests, “animals hail us to account for the regimes in
which they and we must live” (Haraway 2003). One of the most...

10. STUMBLING TOWARD BIOETHICS: HUMAN EXPERIMENTS POLICY AND THE EARLY COLD WAR

Despite a burgeoning literature on bioethics and the history of bioethics, little has been written about the relationship between the origins of modern bioethics in the later 1960s and the human-experiment policies and practices of U.S. national security agencies during the preceding decades. A notable exception was the work of the President’s Advisory Committee on Human Radiation...

PART TWO: THE CONFLICTED PRESENT AND THE WORRISOME FUTURE

11. TOWARD AN ETHICS OF IATROGENESIS

“Iatrogenesis” is a term with Greek roots that literally means “doctor-originated.” It is customarily applied to the negative side effects of the actions that physicians take in their one-on-one care of individual patients. However, the concept is also applicable to the adverse effects that medical or public health interventions can have on groups of individuals—both on persons for whom these...

In Japan today, through what might be called “reckless medicine”—specifically,research on human cloning and the use of embryonic stem cells—there has come into being a frenzied effort, inhumane and excessively optimistic, to reconstruct what is fundamentally human. Why has this “reckless medicine” emerged in Japan? Our urgent task is to investigate the meaning of this development...

13. THE AGE OF A "REVOLUTIONIZED HUMAN BODY" AND THE RIGHT TO DIE

Over the last twenty-five years the most active front in scientific and technological advancement was no longer in the physical sciences but in the biological ones. Among these advances, those within the field of medicine—a field intimately bound up with being born, being ill, aging, and dying—have rapidly increased the pace of their development, beginning with the complete mapping...

14. WHY WE MUST BE PRUDENT IN RESEARCH USING HUMAN EMBROS: DIFFERING VIEWS OF HUMAN DIGNITY

Those who are attempting to rationalize scientific research on human embryos often bring up comparisons to abortion. The question, for example,of whether or not to approve the genetic diagnosis of a fertilized egg prior to its implantation is often discussed through that comparison. This occurred even in Japan. The Research Council in Bioethics, established by Prime Minister...

15. EUGENICS, REPRODUCTIVE TECHNOLOGIES, AND THE FEMINIST DILEMMA IN JAPAN

In the last few decades, people living in the highly industrialized world have witnessed the rapid and rampant development of reproductive technologies in the areas of fertility treatment and prenatal screening. Changes in technology can bring important changes in the way people think about reproduction, family and children, and life itself—but development in the medical field tends to ...

Historical events and processes do not make clones of themselves. Exact replicas will not show up even in much later times—simply because each event and each historical process possesses its own particularities. Yet we scrutinize the past because, in spite of such particulars, some features, sequences, or reasoning processes tend to reappear. If that were not so, and if each event were presumed...

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